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(Reuters) - President Barack Obama took an opening shot at conservative justices on the Supreme Court on Monday, warning that a rejection of his sweeping healthcare law would be an act of "judicial activism" that Republicans say they abhor.

Obama, a Democrat, had not commented publicly on the Supreme Court's deliberations since it heard arguments for and against the healthcare law last week.

Known as the "Affordable Care Act" or "Obamacare," the measure to expand health insurance for millions of Americans is considered Obama's signature domestic policy achievement.

A rejection by the court would be a big blow to Obama going into the November 6 presidential election.

Republican presidential candidates, who are vying to take on Obama in November elections, have promised to repeal the law if one of them wins the White House.

Obama's advisers say they have not prepared contingency plans if the measure fails. But the president -- who expressed confidence that the court would uphold the law -- made clear how he would address it on the campaign trail if the court strikes it down.

"Ultimately, I am confident that the Supreme Court will not take what would be an unprecedented, extraordinary step of overturning a law that was passed by a strong majority of a democratically elected Congress," Obama said at a news conference with the leaders of Canada and Mexico.

Conservative leaders say the law, which once fully implemented will require Americans to have health insurance or pay a penalty, was an overreach by Obama and the Congress that passed it.

The president sought to turn that argument around, calling a potential rejection by the court an overreach of its own.

"And I'd just remind conservative commentators that, for years, what we have heard is, the biggest problem on the bench was judicial activism, or a lack of judicial restraint, that an unelected group of people would somehow overturn a duly constituted and passed law," Obama said.

"Well, this is a good example, and I'm pretty confident that this court will recognize that and not take that step," he said.

Re: Judge Finds Portion of Health Care Reform Unconstitution

Europe is scratching its head over the possibility that the U.S. Supreme Court will strike down President Obama's signature legislative achievement. As the judiciary and the Obama administration trade legal barbs over the high court's authority, the idea that health care coverage, largely considered a universal right in Europe, could be deemed an affront to liberty is baffling.

"The Supreme Court can legitimately return Obamacare?" asks a headline on the French news site 9 POK . The article slowly walks through the legal rationale behind the court's right to wipe away Congress's legislation. "Sans précédent, extraordinaires" reads the article. In the German edition of The Financial Times, Sabine Muscat is astonished at Justice Antonin Scalia's argument that if the government can mandate insurance, it can also require people to eat broccoli. "Absurder Vergleich" reads the article's kicker, which in English translates to, "Absurd Comparison." In trying to defeat the bill, Muscat writes, Scalia is making a "strange analogy [to] vegetables."

Over in Britain, the opposition is more direct. The Guardian's Kevin Powell called the debate "surreal" in his Monday column. "Wasn't the point to make sure the richest and most powerful nation on the planet could protect its own people, as other nations do?" he wrote. "If Americans are promised not just liberty but life and happiness, is there not a constitutional right to affordable healthcare?"

The Independent's Rupert Cornwell, meanwhile, is astonished by the high court's legal sway. "When an American president nominates a new member of the Supreme Court, I sometimes used to wonder, why all the fuss? Is this appointment of a single judge – just one justice among nine – really important enough to throw Congress into a spin, dominate the blogosphere and mobilise every lobbying group in the land?" All the while, Britain's Telegraph publishes a piece by American Mark McKinnon who marvels at the court's power. "These six men and three women will have a voice in determining not only Obama's long-term legacy, but also his short-term future as the November election looms," he writes. "They are six men and three women, aged between 51 and 79, and two of them have been in the same job since Ronald Reagan was in the White House." What can we say? Welcome to America, Europe.

Re: Judge Finds Portion of Health Care Reform Unconstitution

(Well, let's see. You've only known for three years that 1) this package was going to the Supreme Court, and 2) that it was 50/50 once it got there that it would be declared unconstitutional. Sorry, but I think Sebelius is a moron who would have been fired years ago if she was not a government employee)

Kathleen Sebelius: We don't have a health care backup plan

By J. LESTER FEDER
4/12/12 1:54 PM EDT

HHS Secretary Kathleen Sebelius said Thursday that it would “probably” be a good idea for the department to have a backup plan in case the Supreme Court strikes down the health reform law, but the department isn’t working on one.

Asked by a reporter after a speech to the National Action Network whether it would be “prudent” to have a contingency plan in place before the Supreme Court rules, Sebelius responded, “probably so.”

But, she continued, “that isn’t where conversations are headed right now, and I’m confident that it is constitutional.”

She added, “We will eventually, I’m sure, have a plan, but that really isn’t where time and energy is focused right now

Re: Judge Finds Portion of Health Care Reform Unconstitution

There's a back-up plan--single payer. If they want to kill the ACA, then Congress will have no other moral course but to enact dramatic new expansions in Medicaid.

::

About Sebelius, her administration has been unlike any other I've seen. Our government clients in HHS always have a strong opinion about the HHS Secretary, either positive or negative. It's something they mutter to us lowly contractors off the record in hushed tones. But it's been really strange that none of our HHS clients seem to have a strong opinion one way or another about Sebelius. It's like she's just... there and blips on the screen about once a year. (Seemed like she handled the HHS Rule pretty well, based on what I saw of the Sunday morning news shows. But other than that, I have no idea what she has done with her time.)

Re: Judge Finds Portion of Health Care Reform Unconstitution

Originally Posted by dryrunguy

Europe is scratching its head over the possibility that the U.S. Supreme Court will strike down President Obama's signature legislative achievement. As the judiciary and the Obama administration trade legal barbs over the high court's authority, the idea that health care coverage, largely considered a universal right in Europe, could be deemed an affront to liberty is baffling.

"The Supreme Court can legitimately return Obamacare?" asks a headline on the French news site 9 POK . The article slowly walks through the legal rationale behind the court's right to wipe away Congress's legislation. "Sans précédent, extraordinaires" reads the article. In the German edition of The Financial Times, Sabine Muscat is astonished at Justice Antonin Scalia's argument that if the government can mandate insurance, it can also require people to eat broccoli. "Absurder Vergleich" reads the article's kicker, which in English translates to, "Absurd Comparison." In trying to defeat the bill, Muscat writes, Scalia is making a "strange analogy [to] vegetables."

Over in Britain, the opposition is more direct. The Guardian's Kevin Powell called the debate "surreal" in his Monday column. "Wasn't the point to make sure the richest and most powerful nation on the planet could protect its own people, as other nations do?" he wrote. "If Americans are promised not just liberty but life and happiness, is there not a constitutional right to affordable healthcare?"

The Independent's Rupert Cornwell, meanwhile, is astonished by the high court's legal sway. "When an American president nominates a new member of the Supreme Court, I sometimes used to wonder, why all the fuss? Is this appointment of a single judge – just one justice among nine – really important enough to throw Congress into a spin, dominate the blogosphere and mobilise every lobbying group in the land?" All the while, Britain's Telegraph publishes a piece by American Mark McKinnon who marvels at the court's power. "These six men and three women will have a voice in determining not only Obama's long-term legacy, but also his short-term future as the November election looms," he writes. "They are six men and three women, aged between 51 and 79, and two of them have been in the same job since Ronald Reagan was in the White House." What can we say? Welcome to America, Europe.

Re: Judge Finds Portion of Health Care Reform Unconstitution

Originally Posted by Moose

(Well, let's see. You've only known for three years that 1) this package was going to the Supreme Court, and 2) that it was 50/50 once it got there that it would be declared unconstitutional. Sorry, but I think Sebelius is a moron who would have been fired years ago if she was not a government employee)

Kathleen Sebelius: We don't have a health care backup plan

By J. LESTER FEDER
4/12/12 1:54 PM EDT

HHS Secretary Kathleen Sebelius said Thursday that it would “probably” be a good idea for the department to have a backup plan in case the Supreme Court strikes down the health reform law, but the department isn’t working on one.

Asked by a reporter after a speech to the National Action Network whether it would be “prudent” to have a contingency plan in place before the Supreme Court rules, Sebelius responded, “probably so.”

But, she continued, “that isn’t where conversations are headed right now, and I’m confident that it is constitutional.”

She added, “We will eventually, I’m sure, have a plan, but that really isn’t where time and energy is focused right now

There's a back-up plan--single payer. If they want to kill the ACA, then Congress will have no other moral course but to enact dramatic new expansions in Medicaid.

::

About Sebelius, her administration has been unlike any other I've seen. Our government clients in HHS always have a strong opinion about the HHS Secretary, either positive or negative. It's something they mutter to us lowly contractors off the record in hushed tones. But it's been really strange that none of our HHS clients seem to have a strong opinion one way or another about Sebelius. It's like she's just... there and blips on the screen about once a year. (Seemed like she handled the HHS Rule pretty well, based on what I saw of the Sunday morning news shows. But other than that, I have no idea what she has done with her time.)

I'm torn on the issue of who is responsible for a back-up plan. I mean, the plan in place was the Republicans plan, at least until a Democrat signed it into law. It was a compromise already. Yes, Sebelius and Obama are in power, so they need to come up with something else (and I agree that single payer seems to be the alternative). On the other hand, the conservative mantra has been repeal and replace. Where is the replace part?

Re: Judge Finds Portion of Health Care Reform Unconstitution

Originally Posted by shtexas

I'm torn on the issue of who is responsible for a back-up plan. I mean, the plan in place was the Republicans plan, at least until a Democrat signed it into law. It was a compromise already. Yes, Sebelius and Obama are in power, so they need to come up with something else (and I agree that single payer seems to be the alternative). On the other hand, the conservative mantra has been repeal and replace. Where is the replace part?

The same place where it's been the past few years... The Ayn Rand Paul Ryan "plan"... Why replace it when you can completely dismantle it?

Re: Judge Finds Portion of Health Care Reform Unconstitution

Plus, whatever the backup plan is, it will ultimately come from Congress not HHS. So, there is little point in Sebelius having her staff waste their time worrying about it. The talking point of the Obama administration has been that it is consitutitional so they aren't working on anything else, but npr makes it sound like the worst kept secret in town that the White House is considering a variety of options. While the HHS as a whole is a governmental organization bound to no party or line of thinking, Sebelius herself is a political appointee so she will be expected to echo the administration's line of thinking in this regard. She has likely been part of discussions about what the administration should do, but as anyone who works for government knows, it's the politicians who ultimately decide the course of action and like it or not the agency is left to administer it.

Re: Judge Finds Portion of Health Care Reform Unconstitution

[BTW, Rick Ungar is active on Facebook and regularly interacts with his readers. Feel free to send him a friend request. He'll accept, and you can get his articles faster. He focuses mostly on health reform but sometimes delves into Scott Walker issues.]

Congressional Republicans are beginning to face up to the reality that, should the Supreme Court wipe out the Affordable Care Act, their party is going to have to be ready with something to offer up in its place.

Word of what is under consideration in Congressional closed-door sessions and Romney campaign policy meetings is beginning to leak out and—from what I am hearing—if you are a member of the once great American middle-class, good luck to you.

You are most assuredly going to need it.

At the heart of the GOP healthcare scheme is the notion that government’s interference with our healthcare system encourages consumers to be wasteful in what they spend on healthcare. This, as the meme goes, is the result of government and the nation’s employers footing most of the costs, leaving consumers—with no financial skin in the game—to be completely careless about their healthcare spending habits.

It’s like that time you needed the triple-bypass and wastefully chose to have an experienced surgeon do the job at a reputable hospital rather than heading on down to Dr. Sam’s Surgery Swamp where Tuesday is Cholesterol Day —and that means fix one clogged coronary artery and the second one is free!

While the Republicans would have us believe that free markets in medicine are ‘the answer’, the GOP does recognize that some government assistance will still be required.

That assistance is likely to come in a few formats —defined benefit “premium support” (fixed vouchers) for those on Medicare, block grants to the states for Medicaid and tax credits for everyone else.

I think we already know how our nation’s elderly feel about the voucher approach introduced by Congressman Paul Ryan. Can anyone be surprised that our senior citizens, and those approaching the age of Medicare who would be affected by the policy change, are less than thrilled with being cast into the viper pit of the private, for-profit health insurance companies as these old folks become increasingly more responsible to pay for costs that exceed the value of their vouchers?

But what about the rest of us—and when I say, ‘the rest of us’, I mean hard-working Americans who are not wealthy but manage to support their families on average incomes?

The thinking goes that by providing Americans with a tax cut, the government will give us a ‘leg up’ when it comes to helping us afford health insurance. At the same time, allowing the markets to establish a better price for health insurance policies—as insurers compete for your business without prices being skewed by government interference and we become more cost conscious because we are spending our own money—the GOP believes that prices will necessarily go down.

Re: Judge Finds Portion of Health Care Reform Unconstitution

Originally Posted by dryrunguy

[BTW, Rick Ungar is active on Facebook and regularly interacts with his readers. Feel free to send him a friend request. He'll accept, and you can get his articles faster. He focuses mostly on health reform but sometimes delves into Scott Walker issues.]

Congressional Republicans are beginning to face up to the reality that, should the Supreme Court wipe out the Affordable Care Act, their party is going to have to be ready with something to offer up in its place.

Word of what is under consideration in Congressional closed-door sessions and Romney campaign policy meetings is beginning to leak out and—from what I am hearing—if you are a member of the once great American middle-class, good luck to you.

You are most assuredly going to need it.

At the heart of the GOP healthcare scheme is the notion that government’s interference with our healthcare system encourages consumers to be wasteful in what they spend on healthcare. This, as the meme goes, is the result of government and the nation’s employers footing most of the costs, leaving consumers—with no financial skin in the game—to be completely careless about their healthcare spending habits.

It’s like that time you needed the triple-bypass and wastefully chose to have an experienced surgeon do the job at a reputable hospital rather than heading on down to Dr. Sam’s Surgery Swamp where Tuesday is Cholesterol Day —and that means fix one clogged coronary artery and the second one is free!

While the Republicans would have us believe that free markets in medicine are ‘the answer’, the GOP does recognize that some government assistance will still be required.

That assistance is likely to come in a few formats —defined benefit “premium support” (fixed vouchers) for those on Medicare, block grants to the states for Medicaid and tax credits for everyone else.

I think we already know how our nation’s elderly feel about the voucher approach introduced by Congressman Paul Ryan. Can anyone be surprised that our senior citizens, and those approaching the age of Medicare who would be affected by the policy change, are less than thrilled with being cast into the viper pit of the private, for-profit health insurance companies as these old folks become increasingly more responsible to pay for costs that exceed the value of their vouchers?

But what about the rest of us—and when I say, ‘the rest of us’, I mean hard-working Americans who are not wealthy but manage to support their families on average incomes?

The thinking goes that by providing Americans with a tax cut, the government will give us a ‘leg up’ when it comes to helping us afford health insurance. At the same time, allowing the markets to establish a better price for health insurance policies—as insurers compete for your business without prices being skewed by government interference and we become more cost conscious because we are spending our own money—the GOP believes that prices will necessarily go down.

I'm beginning to think some of these guys designed the subway stations Suliso showed un on the other thread. What world are they living in? The food is poisoned. Water in many parts of Appalachia and other areas is polluted. The air we breathe isn't safe. And they think people are, as you say Dry, randomly decided to have bypass surgery?

I hope they do roll some nonsense like this out.

Oh heaven...I wake with good intentions but the day it always lasts too long... Emeli Sande

Re: Judge Finds Portion of Health Care Reform Unconstitution

I heard something the other day about Romney's plan taking the tax breaks away from the employers and giving them to the employees. Which, of course, means that employees with health care will most assuredly lose it and have to fend for themselves. But, they get a tax break!

Re: Judge Finds Portion of Health Care Reform Unconstitution

I've been in several meetings over the past few days about what's happening at the state levels in terms of the integration of public sector mental health and substance abuse services (which are slowly being integrated into merged behavioral health services) into primary care. It's very complicated stuff. But throughout these meetings, one of the underlying themes, of course, has been health reform.

It's very interesting to see what's happening in the states. They're basically falling into two groups--one group is rapidly moving forward in terms of preparing for the major provisions of the ACA, while the other group is standing still and basically resisting any kind of reform.

What became very clear in listening to the experts at the national level who can tell you off the tops of their heads what is happening, or not happening, in every state is that even if the individual mandate is scrapped and the entire ACA begins tumble, the states preparing for reform are going to move forward anyway because they are already seeing the benefits of program and service integration, electronic health records, health insurance exchanges, etc. Plus, they've already invested so much in terms of developing the infrastructure and have come so far that it would be silly not to finish where the ACA was taking them.

So what's basically happening is that the gap will continue to widen among the states in the next few years. One group of states is going to complete this transformation, and those are going to be the states in which those who rely on public sector systems for care will want to live. The other group of states, which are generally those that have launched lawsuits against the ACA, will be back in the dark ages in comparison, where those who receive public sector care will be served by fragmented, siloed systems where there is little to no integration, few quality measures, archaic patient record systems, and public sector mental health/substance treatment dollars are at risk of being slashed and burned or thrown entirely into Medicaid with no protections or guarantees for people who need mental health care or drug treatment... among many other things. If the ACA is upheld by the SCOTUS, these states could be in some very, very serious doodoo, and it will basically be impossible for them to catch up. It's scary.

But the main point here was this: regardless of what the SCOTUS decides, public sector reform is going to happen in most states regardless. Even some private sector insurers like United have indicated that they'll maintain the vast majority of benefits mandated in the ACA because active prevention-based care is saving them boatloads of money (and no doubt, increasing their profits significantly).